Recent hurricane events in coastal Louisiana have emphasized the severe vulnerability of medical special needs (MSN) patients during flood disasters. MSN populations may be comprised of hospital, nursing home or hospice patients; the physically or mentally disabled; medically-dependent individuals requiring life-sustaining equipment or medicines; and frail elderly.

Over 150 hospital and nursing home fatalities resulted from Hurricane Katrina in New

Orleans. More than four hundred elderly over the age of seventy perished. Chronic diseases and

mental health illness were among the top conditions reported in field hospitals, emergency rooms and shelters immediately following the storm.

Louisiana MSN facilities and residences in the southern-most parishes continue to face

daunting risks from even minor storms. Principal risks include storm surge and high winds made

worse by coastal land loss. Few structures have been designed to withstand hurricane forces and

many depend on coastal hurricane protection systems. Many are located in close proximity to

industrial facilities or hazardous material sites.

Meanwhile, MSN patients and decision-makers lack access to the latest hurricane science. This prevents them from conceptualizing their true hurricane vulnerability. Indications were that high numbers of MSN patients remained in the risk area even while Category 5 Hurricane Katrina loomed towards Louisiana. Many still plan to shelter in place for hurricanes.

This manuscript reviews the health and hurricane risks of MSN patients in evacuation vs.

sheltering in place in coastal Louisiana. The latest hurricane models are incorporated with

critical MSN location data in a Geographic Information System (GIS) to determine threshold events. Solutions are explored to communicate risk, visualize data, and share hurricane research

and GIS tools with MSN decision-makers at the local level.

Based on scientifically accredited modeling and associated research, this study has determined the threshold storm event for coastal Louisiana MSN patient evacuation to be a tropical storm. Particularly, rapid hurricane intensification has historically supported that even lower order storms may intensify enough within 48 hours of landfall to create unsafe flood and wind levels. Thus, full MSN patient evacuation south of the Louisiana interstates is recommended upon a tropical storm entering the Gulf of Mexico.